Project Summary Kinship care families (e.g., grandparent raising grandchildren) are rapidly increasing. Approximately 2.5 million grandparents are the primary caregivers for their grandchildren, and African Americans (AA) are more likely to be kinship caregivers than persons from other groups, making them one of the nation?s most vulnerable populations. Kinship caregivers face unique challenges, such as parenting for uncertain periods of time, often with scarce financial resources, while balancing potential conflicts with the child?s biological parents, placing them at significant risk for high stress levels. Given recent findings of links between chronic stress and Alzheimer?s disease (AD), there is a need for research to identify possible stressors and mitigate risks for outcomes such as AD among kinship caregivers. Over the long term, caregivers incur a host of negative stress-related outcomes, including poor physical and mental health. Additionally, since AAs are two to three times more likely to develop AD than their Caucasian counterparts and are disproportionately affected by cardiovascular disease, a risk factor for AD, there is an urgent need for research to identify modifiable risk factors for both stress and cardiovascular disease, to potentially mitigate the onset of AD in kinship caregivers. The aim of this two-phase mixed methods study is to identify: a) risk factors for stress and cardiovascular disease in a sample of AA kinship caregivers, b) positive lifestyle behaviors that AA kinship caregivers rely on to reduce their stress and promote physical health, and c) negative coping strategies that might amplify poor physical and mental health outcomes. Our long-term goal is to develop knowledge to develop culturally informed interventions for AA kinship caregivers that address modifiable risks for both chronic stress and cardiovascular disease, with the long term goal of reducing risks for AD. As an Administrative Supplement, this project will build on the parent R15 grant, which examines kinship care families? impact on children?s outcomes, to now examine kinship caregiver outcomes. If kinship caregivers do not remain healthy, their lives ? and those of the children they care for ? will be significantly compromised. The proposed supplemental study is a natural extension of the parent R15 grant, and it will use a subsample from the R15 cohort to implement the study.